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Home My WebLink AboutVido Bid Package Diamond BarEXPERIENCE STATEMENT To be responsive, the bidder must list ]:elow a minimum of three public agencies for which bidder has performed sinilar work within the past threeyears. Only projects in excess of $250r000 each qualify as similar for this project. Proj ect Contract Type of Client r-LLte ***SEE ATTACHED COMPLETED PROJECT REFERENCES*** Agency Project Manager Phone Date Completed i\ Subcoittractecl Amount Work 2.Proj ect Contract Type of CIient Proj ect Contract Type of Client Amount Work Title TitIe Agency Project Manager Date Cornpleted F'hone 1]: Subcont::ac1-ed ? Amount Work Agency Pr:oject- IvTana ger Date Completed NOTE: If requested by the City, financial st.atement, references/ comprehensj-ve to permit an apprais Bidder's Signature Phone rq Subcontracted bidder shall furnish other information the and lof a certified suf f rcient.ly condition. 1O 1. VIDO SAMARZICH, [NIC. General Engineering Contractor No. 4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 9]7OI TELEPHONE 909-987-6377 FAX 909 987_B9BB COMPLETED CONSTRUCTION PROJECT REFERENCES l. Project Name: Santa Ana Illvd ancl 5'l'St I)rotcctccl Ilil<c Lanc Owner: Clity of Santa Ana Phonc Number: (714) 647-5655 Engineer/Contact: Mr. Scarr'l'hontas Contract Amount: $6,1 00.000.00 Datc of Cornpletion: 2023 2. Project Namc: Ocean tllvd Sidewalk Illprovcntents Owner: City of Ncwport lleach Phone Number: (714) 552-5336 Engincer/Contact: Mr. Michael Sinacori Contract Amount: $5 I 4.000.00 Date of Completion: 2022 3. Project Name: Annual Sidewalk Intprulvertrcnl l)ritjccl Owner: City of l)ico Rivela Phone Number: (562) 801-4221 Bngineer/Contact: Ms. Naclia Carrascct Contract Amount: $375.000.00 Date of Completionz 2022 4. Proiect Namc: Safe Routes to School Pro.jcct Owner: City o1' Monrorzia Phone Num ber: (7 60) 220-07 22 Engineer/Contact: Mr. .lames Merrell Contract Amount: $356.000.00 Date of Completion: 2022 5. I'}roject Name: Local Street CLrrb I{ant1-r Ir-nprclvcr.ncnts Phasc II Owner: City of Santa Ana Phone Numher: (714) 552-5336 E,ngincer/Contact: Mr, Gcrardo Lcchuga Contract Amount: $399.000.00 Date of Completion: 2020 I)agc I o1'8 VIDO SAMARZICH, INC. Getreral Engirreering Contractor No.4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 9Il01 6. Project Name: Etiwanda Corriclor Intprovcntcnls l)ro.jcct Owner: City of Rialto Phone Number: (714) 381-2410 Engincer/Contact: Mr. Fred Alipanah Contract Amount: $1.098.000.00 Date of Completion: 2020 7. Project Name: Residential Slreet Inrprovonenls []ishop St ancl fLaitt St Owner: City of Santa Ana Phone Number: (714) 615-0892 Engineer/Contact: Mr. Michacl Ortiz. Contract Amount: $1,279.000.00 Date of Completion: 2020 8. Project Name: Residential Street Repair Progranr I,'Yltt/19 Owner: City of Santa Ana Phone Number: (714) 61 5-0t192 llngineer/Contact: Mr. Michael Ortiz Contract Amount: $876.000.00 Date of Completion: 2020 9. Project Name: Sidewalk Gap Closure Pro.iect Owner: City of Pahr Springs Phone Number: (760) 323-8253 x8744 Engineer/Contact: Mr. Donn IJyeno Contract Amount: $1,267,000.00 Date of Completion: 2020 10. Project Name: Misc Stonl Drain Intprovcnrents - 335 S. IIale Ave Owner: City ol' Fullerton Phone Number: (714) 738-6853 Engineer/Contact: Mr. Davic'l Grantharr Contract Amount: $200.000.00 Date of Completionz 2020 I l. Pro,iect Name: Misc Stonrr Drairr Intprovcntents Knclrp Avc Owner: City of liullertotr Phone Number: (714) 738-6853 Engineer/Contact: Mr. David Gtanthartr Contract Amount: $304.000.00 Date of Complction: 2019 TELEP HO NE 9 09 -9 87 - 637 7 FAX 909-987-B9BB l'}agc 2 ol'ti VIDO SAMARZICH, INC. Ger-reral Engineering Contractor No. 4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 917OI IELEPHONE 909-987_6377 FAX 909-9B7,B9BB 12. I'roject Name: Local Street Cr"rrb l{amp Intprutr,.cntcr.tts Owner: City of Santa Ana Phone Number: (714) 552-5336 Engineer/Contact: Mr. Gerardo Lechuga Contract Amount: $577.000.00 Date of Completion: 20I 9 13. Project Name: 3"1 Ave Pavement l{ehabilitation ancl Water Inrprovcntcnts Owner: City of tJpland Phone Number: (909) 291-2946 Engineer/Contact: Mr. Bob Critchfi eld Contract Amount: $2,800.000.00 Date of Completion: 2019 14. I'roject Name: 9tl' Street Pavement Rehabilitation ancl Walcr Improvenrents Owner: City of tJpland Phone Number: (909) 291-2946 Engineer/Contact: Mr. Uob Critchfleld Contract Amount: $2.600.000.00 Date of Completion: 2019 15. Project Name: La Palma Ave Sider,valk Ir.nprovcntents Owner: City of Anahein'r Phone Number: (714) 765-5052 Engineer/Contact: Mr. .loel .lordan Contract Amount: $479.000.00 Date of Completion: 2019 16. Project Name: Wilshire Avenue []icyclc lllvd Inrprorzentents Owner: City of Fullerton Phonc Number: (714) 738-6ti,53 Engineer/Contact: Mr. David (lranthant Contract Amount: $2, 1 00.000.00 I)ate of Completion: 2019 17. Proiect Name: FY l7-18 ADA Access I{amp Improvenrctrts a1 Various Locations Owner: City of Rancho Cucamonga Phone Number: (909) 774-4070 Engineer/Contact: Mr. Rornco David Contract Amount: $975.000.00 Date of Completion: 2018 l']age 3 ol'8 VIDO SAMARZICH, fNC. General Engineering Cor-rtractor No. 4s32ro A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 9]70I 18. Project Name: Wilshire AvenLrc Water ancl Scrvcr inrprovcn.rcnt l)ro.jcc1 Owner: City of Fr,rllerton Phone Number: (714) 738-6895 Engineer/Contact: Mr. Gar IILrang Contract Amount: $550.000.00 Date of Completion: 2018 I9. Project Namc: Elrl/Maldcn Area Strcel. Scr,r,er aucl Water Inrprovcnrcnts C)wner: City of Fr-rllerton Phone Number: (7 1 4) 773-0049 Bngincer/Contact: Mr. .loseph l Iernandcz Contract Amount: $2.200.000.00 Date of Completion: 2018 20. Project Name: Anahcim IIills Road watcr Main ltcplacenrcr.rt Owner: City of Anahcint TELEP HO NE 9 09 -987. 637 7 FAX 909_98/.B9BB Phone Number: (714) 86:l-8020 Bngineer/Contact: Mr. I-r"ris'l-apia Contract Amount: $600.000.00 Date of Completion: 2018 21. Project Name: CDBG ADA Wheelchair Acccss I{anrp I{cl.rlaccnrcnt a1 Various Locltiels Owner: City of Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew l-orcnzer.r Contract Amount: $204"300.00 Date of Completion: 2018 22. Project Namc: 2017 Citywide CLrrb I{amp Intpu,cntents Owncr: City of Laguna Beach Phonc Number: (81 8) 402-0225 Engineer/Contact: Mr.'fri Nguyen Contract Amount: $285.000.00 I)ate of Complction: 201 7 23. Pro.ject Name: Saf'e lloules to School Irtrprovcrlcnls. l)hasc 3 C)wner: City of Glcndalc Phone Number: (81 8) 402-0225 Engineer/Contact: Mr. Gary trclsall Contract Amount: $908.000.00 Date of Completion: 2017 l)agc -l ol-8 VIDO SAMARZTCH, fNC. Ger-reral Er-rgineering Contractor No. 433z 0 ^ 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 9170I 24. Project Name: Heirr Ave at Canal St Stornr Drain Inrprovcnrents Owner: City of Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew Lorcnzerr Contract Amount: $99.000.00 Date of Completion: 2017 25. Project Name: Citywide Sidewatl< Repair Pro.ic.ct Ity l-5-16 Owner: City of Santa Monica Phone Number: (951) 522-4505 Engineer/Contact: Mr. Craig Wheeler Contract Amount: $878.000.00 I)ate of Completion: 2017 26. Project Namc: IrY 16/17 cLrrb Access I{anrp Installation projcct Owner: City ol' IJr-rntington Ileach Phone Number: (714) 536-5259 Engineer/Contact: Mr. .loe Fuentes Contract Amount: $679.000.00 Date of Completion: 2017 27.Pro.iect Name: conrstocl< Avenue water Main Inrpnrr,cnrents Owner: City of Whittier Phone Number: (562) 567-9302 Engineer/Contact: Mr. Carl []assel Contract Amount: $578.000.00 Date of Completion: 2017 28. Project Name: Monterey Road Street In-rproven-tcnts Owner: City of Sor.rth Pasadcna Phone Number: (626) 590-0570 Engineer/Contact: Mr. Alex ChoLr Contract Amount: li1.550.000.00 Date of Complction: 201 7 29. Project Name: F-lctcher Avenue Recoltslruction Owner: City of Sor-rth Pasadena Phone Number: (702) 204-4025 Engincer/Contact: Mr. Mark l)etersorr Contract Amount: $878.000.00 Date of Completion: 2016 TE LEP HO NE 909 _9 87, 637 7 FAX 909-987-B9BB I)asc 5 o1'8 VIDO SAMARZICH, fNC. Geueral E,ngilteering Contractor No. 4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CAIIFORNIA 9170I 30. Project Name: Patterson Strect Reconstruction f)wner: City o1' lrullerton Phone Number: (714) 732-9060 Engineer/Contact: Mr. l)cte Acosta Contract Amount: $675.000.00 Dnte of Completion: 201 6 31. Project Name: Magnolia/Bolsa Interscction Wiclclting Owner: City of Westntinster Phone Number: (714) 548-3464 Enginecr/Contact: Ms.1'hercsa'I'ran Contract Amount: li978.000.00 Date of Cornpletion: 2016 32. Pro.iect Name: 2015 Water Main Irtrproventcr.rts Orvner: City o1' Westminster Phone Number: (714) 548-3456 Engineer/Contact: Mr.'luan Phant Contract Amount: $ 1 .l 00.000.00 Date of Completion: 20i 6 33. Project Name: Red I{ill Lal<e Modernization C)wncr: City of Ranclto Cucantongn Phone Numbcr: (909) 417-2740 Enginecr/Contact: Mr. Romcct Davicl Contract Amount: $300"000.00 Date of Complction: 201 6 34. l'}ro.ject Name: 2015 Concrele Intproventents Owner: City of Inglewood Phonc Number: (714) 468-7319 Engineer/Contact: Mr. IIr.rnter Ngr-ryen Contract Amount: $425.000.00 Date of Completion: 201 5 35. Pro.iect Name: El Centro Avcnue llchabilitation Owner: City of South Pasadena Phone Number: (626) 590-0570 Engineer/Contact: Mr. Alcx ClhoLr Contract Amount: $ I .l 00.000.00 Date of Completion: 2015 TELEPHO NE 909 -9 87 -637 7 FAX 909-987-B9BB I)agc 6 ol'8 VIDO SAMARZTCH, INC. General Engineering Cor-rtractor No.4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFCRNIA 9I70I 36. Project Name: Coltcrete Bus Pacls Owner: City of Rancho Cucanronga Phone Number: (714) 548-3456 Engineer/Contact: CLrrt Billings Contract Amount: $1 75.000.00 Date of Completion: 201 5 37. Project Namc: ADA Wheelchair Ranrps Owner: City of Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew Lorenzcr.r Contract Amount: 18275.000.00 Datc of Completion: 2015 38. I'roject Namc: 2014 Water Improvement Owner: City of Westminster Phone Number: (714) 548-3456 Engineer/Contact: Mr.'l'uan Phan.r Contract Amount: $ I .l 00.000.00 Date of Completion: 2015 39. Project Namc: ADA Sidewalk Intproventcltt C)wner: City of Artesia Phone Number: (951 ) 3 14-6984 Engineer/Contact: Mr. Chr-rcl< Br-rrl<lrarclt Contract Amount: $200.000.00 Date of Completionz 2014 40. Project Name: YLHS Parl< Bryant Cross l,'cedcr pipcline Owner: Yorba Linda Water District Phone Number: (714) 701-3 I 04 Engineer/Contact: Mr. Joc Polinrino Contract Amount: $675.000.00 Date of Completion: 2013 41. Project Name: County Road Stonn Drain Owncr: City o1'Pomona Phone Number: (909) 322-7471 Engineer/Contact: Mr. Dave Barron Contract Amount: Xi570.000.00 Date of Completion: 20,l3 TELEPHO NE 9 09 -9 B/ _ 637 7 FAX 909,987-B9BB Page 7 of8 VIDO SAMARZICH, fNC. General Errgirreering Cor-rtractor No. 4332r0 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIF'ORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987_B9BB 42. Project Name: Aclants Sqr-rare Park C)wner: City ol Glendale Phone Numbcr: (81 8) 548-2864 Engineer/Contact: Mr. I-lagop Kassabian Contract Amount: $i I .I 00.000.00 Date of Completion: 2010 43. Project Name: Various l)ublic Work l)urchase Orc'lers and Contracts 2000-2013 C)wner: City of Pasadcna Phone Number: (626) 484-5640 Engineer/Contact: Mr. Dalc'l'orstcnbo - cltorslcn["rorlfcityotpasaclcna.r.rcl Contract Amount: $2,500,000.00 Date of Completion: 2000-2013 44. Project Name: Misc Park Iltrprovcntcnts liror.r.r 2000-2010 C)wner: City of Glenclale Engineer/Contact: George Balteria - (95 1 ) 201 -2710 Peter Vierhei I i g - pvierhci I i g(ri)ci. gl cndal c. ca. us Contract Amount: $3.500.000.00 Date of Completion: 2000-2010 I)agc fl of'fl BIDDERIS PROPOSAL CITY OF DIAMOND BAR AREA 4 RESIDENTIAL NEIGIIBORHOOD ADA CURB RAMP TMPROVEIVIENT PROJECT Date May 3 CDBG PRO,JECT NO. 602604_23 CIP PRO.]ECT NO. ST241O4 | 2024 To the City Councif of the City of Diamontl Bar: The Undersigned hereby declares: (a) That the only persons or part.ies interested rn this proposal asprj-ncipals are the following: Corporation:Vido Samarzich, lnc. Vido Samarzich _ president Vido L. Samarzich - Vice President Monika Samarzich - Secretary (1f the bidder is a corporation, give the name of the corporation and the name of its president, secretary, treasurer, and manager.If a co-partnership, give the name, under which the co-partr-rership does business, and the names and addresses of all co-partners. Ifan individual, state the name under which the contract is to be drawn. ) (b) That thi-s proposal is made without collusion wit.h any person, firmor corporation. (c) That he has carefull-y examined the location of the proposed work and has familiarized himself with all of the physical and climaticconditions. and makes this bid solely upon his own knowledge. (d) That by submittinq this Bidder and knowledge of the contents City of Diamond Bar to him at City of Diamond Bar vrhen this rs Proposal, he acknowledges receipt of those communications sent by the the address furnished by him to theproposal form was obt.ained. (e) That he has carefully examined the specifications, both general and detail, and the drawings attached heret.o, and communicationssent to him as aforesaid, and makes this proposal in accordancetherewith. 15 (f) That, if this bid is accepted he will enter into a writ.ten conLractfor the performance of i:ire proposed work with the City of DianrondBar. (q) That he proposes to enter into such Contract and to accept in fullpayment for the work actually done thereunder the prices shown inthe attached schedule. It is understood and agreed t.hat thequantities set forth are est.imates and t.hat. the unit prices willapply t.o the actual quantities whatever they may be. 10o/o of total bid amount DOLLARS ($). Said bidder's bond has been duly executed by the und.ersigned bidder andby a flnancially souncl surety company authorized t.o transact businessin t.his state. It is understood and agreed that shoufd t.he bidder fait within ten(10) days after award of contract t.o enter into the contract and furnishacceptable surety bonds, then the proceeds of said check, or bidder'sbond, shall- become the property of tl-re City of Diamorrcl Bar; l:ut if thisContract is entered into and said bonds are furnished, or if the bid isnot accept.ed then said check shall be returned to the undersigned, orthe bidder w1ll- be released from the bidder's borrd. 6829 Billings Place 909-987-6377 Address of Bidder Rancho Cucamonga, CA City Zip Code Accompanylng this proposal is a certified or cashier's check or @payab1etotireorderoft-heCityofDiamotldBarinthe sum of 91701 phone of Bidder Signature of 1.b BTD SCHEDULE CITY OF DIAI{OND BAR CONTRACT DOCUMENTS AND SPECIFICATIONS AREA 4 RESTDENTIA], NEIGHBORHOOD ADA CURB RAMP IMPROYEI{ENT PRO,JECT CDBG PROJECT NO. 602604-23 crP PRO,fECT NO. Sr24L04 BASE BID SCHEDULE $72 s20.00 BASE BID SCHEDULE TOTAL AMOUNT (WRITTEN IN I^IORDS) : gqventytwothousand, five hundred twenty dollars. BASE BID SCHEDULE ITEMS: TOTAL AI{OUNT (IN FIGURES)-+ ITEM hio. EST. QUANT.UNIT DESCRI PTIOI{ WR]TTEN IN WORDS UNIT PRICE AMOUNT I I I,S CONSTRUCTION STAKING AND MONL]MENT PRESERVAT]ON.1 ,000.00 1,000.00 2 b E]A REMOVE EXIST]NG ]MPROVEMENTS AND COI{STRUCT CURB RAMP PER SPPWC STD. PLAN NO. 111-5/ TNCLUDTNG MOBIL]ZATION, TRAFFIC CONTROL, AND PUB],IC SAFETY. 1 1,000.00 66,000.00 3 95 SE REMOVE EXISTING CL]RB RAIVIP OR STDEW/\LK AND CONSTRUCT CONCRETE S]DEV{ALK PER SPPWC STD PLAN 7L3-Z and 130-2. 16.00 .1,520.00 4 1 TC!U THERMOPLASTIC TRAFFIC STRIPING, PAVEMENT MARKINGS, AND CURB MARKINGS. 4,000.00 4,000.00 ADD AITERNATE SCHEDULE ] TEM NO. EST. QUANT.UNiT DESCRI PT]ON WRlTTEN ]N WORDS UNIT PRICE A}lOUNT AA- 1 4 EA REMOVE EXIST]I\G ]MPROVEMENTS AND CONSTRUCT CURB RAMP PER SPPWC STD. 13,000.00 52.000.00 L1 lTEM NU. F err' QUANT.UNIT DESCRIPTION WR]TTEN ]N WORDS UNIT PRICE AMOLJNT PLAN NO. 111_5I INCLUDING NIOBILI ZATION, TRAFFIC CONTROL/ AND PUBIIC SAFETY. AA_2 20 eE' REMOVE EXISTING CURB RAMP OR SIDEWALK AND CONSTRI-ICT CONCRETE SIDE}IALI( PER SPPWC STD PLAN 7L3-2 and 1 30-2 . 35.00 700.00 AA-3 2t742 ST REMOVE EXISTING CROSS GUTTER AND RECONSTRUCT PER SPPWC STD. PLAN T22_3,33.00 70.686.00 ADD ALTERNATE SCHEDULE ITEMS: TOTAI AMOUNT (IN F]GURES)_+ $123,386.00 ADD AI,TERNATE SCHEDUT,E TOTAT, AIVIOIJNT (WRTTTEI{ IN WORDS): Onehundred twenty three thousand, three hundred eighty six dollars BASE BTD + ADD AI,TERNATE SCHEDTII,E TTEMS: TOTAI AMOTINT (IN FIGURES)_+ $195,906.00 BASE BID + ADD ALTERNATE SCHEDULE TOTAL AMOL]NT (WR]TTEN ]N WORDS): One hundred ninety flve thousand, nine hundred six dollars. Bid Schedule Note: Bid Price inclicat.eci r:efei:s to all- -i,tems itlust-i:ateclon the plans and details, and delineated withln the specificationsinstalled and comp.letely in place wj-th alI applicabte portions of Lheconstruction documents and include aIl costs connected with such itemsincluding, but t-o necessarily limj.t.ec1 t-o, materials, t,::ansportat-ion,taxes, insurance, labor, overhead, and profit, for General Contractorand Subcontractors. lo Ar1 work called for on the construction documents are completed project with all systems operating properly use. to provlde a and ready for The Contractor shall completely flll out the Bid Schedule includingBase Bid and Add Alternate. Award of the project shal-l be determinecl based on the lowest responsible bidder. The lowest responsible biddershall be calculated on the sum of '.Base Bid, only. Accompanying this proposal is bidder'sbond ( Insert " cashier the case (10?,) of ilC cashtt, 's check", "certif ied check" r or ',bidderrs bond" as may be) in the amount equal to at l-east ten percent the total bid- 5t3t2024 SIGNATURE L]A I -t1 The undersigned further agrees that in case of default inexecuting the required contract, with necessary bond, withinten (101 days, not including sundays and regal holidays, afterhaving recelved notice that the contract has been awarded andready for siginature, the proceeds of the security accompanying his bid shall become the property of the City of Diamond Bar, and this proposal and the acceptance thereof rnaybe considered null and rroid. Vido Samarzich, lnc. NAME OF B]DDER (PRINT) Rancho Cucamonga, CA 91701 909-987-6377 CITY 433210 Class A ZIP CODE TELEPHONE STATE CONTRACTOR LICENSE NO. AND CLASS]FICATION I declare under penalty of Perjury of the l-aws of the State of Californiathat the representations made herein are true and co::.rect in accordancewith the requirements of California Business and Professional CocleSection 1028.L5, CONTRACTOR SIGNATURE OR AUTHORIZED OFFICER 19 Area 4 Resrdential Neighborhood ADAPROJECT Curb Ramp lmprovemdnt proiect LIST OF SUBCONTRACTORS * BID OpENING DATE 5/612024 PROJECT IIO. CIP No. 5124104 LCCAT L-Ol,t Diamond Bar, CA CLIENT City of Diamond Bar CCI'tTRACTOF. VidoSamarzich,lnc. Name Under I,lhich Subcontractor is Llcensed Li-cense No. Address ' UI Office, Mai1, or Shop Percent 9! Total, Contract Specific Description of Subcon"Lract Superior Pavement Markings, lnc./ /bJUb 5312 Cypress St 5.5% Bid ltem #4 Cypress, CA 90630 * In compli-ance with the provisions of the Public Contract CodeSection 4L04, the undersigned bidder herewith sets forth the name,Iocation of the place of business, and California contractor 20 Iicense of each Subcontractor - who will perform work or labor or render service to the Prime Contractor, specially fabricat.es andinstalls a portion of the work or improvement necessary to completeconstruction contained in the plans and specifications, in anamount in excess of one-half (L/2) of one percent (1%) of theGenerar contractor's total base bid amount, or, in the case of bidsor offers for the construction of streets or highways, includingbridges in excess of one-harf of I percent (0.5?)of the prime Contractor's total base bid or ten thousand ($10r 000.00) ,whichever is greater, and the portion of the work which wirr be done by each Subcontractor. 2I DECTARATION OF ELIG]BILITY TO CONTRACT ILabor code section 1111.1; pubric conIract code section 6109] The undersigned, a duly authorized representative of tire conLractor,certifies and declares that: 1. The contractor is aware of Sections L7'11 .1 and 1111 .7 of thecalifornia Labor cocie, wliich prohibit a conL.ractor orsubcontractor who has been found by the Labor Commissioner or theDirector of Indus t,riaI RelaLions Lo be in r.riol-ation of certainprovisions of the Labor code, from bidding onr being awarded, orperfonning work as a subcontractor on a public works project forspecified periods of time. 2. The contracL.or is not ineligible to bid on, be awarded or perform work as a subcontract,or on a public works project by virtue of t.heforegoing provisions of Sections 1111.7 or 7717.1 of the Callfornia Labor Code or another provision of l_aw. 3. The contractor is aware of Californla Public Contract Code Section6109, which sLaLes: (a) A publi-c entity, as defined in Section 1100 [of thePublic Contract Codel, may noL permit a contractor orsubcontractor who is ineligible Lo bid or worl< on, o-r.be awarded, a public works pro3ect pursuanL to Section Llj7.1 or 17'77.1 of t.he Labor Code to bid on, be awarcled, or perform work as a subcontractor orlr a public works project. Everypublic works project. shaIl contain a provision prohibiting acontractor from performing work on a public works project with a subcontractor who is ineriglbre to perform work on thepublic works project pursuant to Section 7'7'11 .1 or llii.T of the Labor Code. (b) Any contract on a public works project entered into between a contractor and a debarred subcontractor is void asa matter of law. A debarred subcontractor may not receive any public money for performi-ng work as a subcontract.or on apublic works contract., and any pubtic money that may have been paid to a debarred subcontractor by a contractor on theproject shall be returned to the awarding body.The contractor shall be responsible for the payment of wages toworkers of a debarred subcontractor who has been allovred to work on the project. The contractor has investigated the eligibitity of each and every subcontractor the contractor intends to use on thj-s public works project, and determined that work as a subcontract.or on a foregoing provisions of t.heor L111.7 of the Labor Code, none of them is ineligible to perform public works project by virtue of thePublic Contract Code Sect.ions 1711.1or any other provision of law. I declare under penalty of perjury under the laws of the State ofCa-l-ifornia t.hat the foregoing is true and correct. Execut.ed thls dayof May 3 , 2024, at Rancho Cucamonga, CA (place of execution) Name: Vido Samarzich Title: president Name of Contractor: Vido Samarzich, lnc. Signature 23 BTDDER ' S VIOLATION OF ],AI{/SAFETY QUESTIONNAIRE In accordance with Government Code Section 14310.5 ancl irr conformancewith Public Contract Code Section 70L62, the Bidder shall complete, under penalty of perjury, the followir-rg questionnaire: QUESTIONNAIRE Has the Bidder, any officer, principal or employee of t.he Bidder whohas a proprietary interesL irr the business of 1-he Bidder, ever beendisqualified, removed, or otherwise prevented from bldding on orcompleting a federal-, state or Iocal gorrernment project because ofviolation of Law or a safety i:egulatlon'? YES If the answer is yes, explaj-n the circumstances in the following space: STATEMENT In conformance with PubIic Contract Code Section 10232, the Contractor,hereby states under penalt.y of per j ury, that no more t.han on f inar unappealable finding of contempt of court by a federal court has beerrissued against the Contractor wlthin the immediately preceding two-yearperiod because of the Contractor's failure to comply with an order ofa federal court which orders the Contractor to comply with an order ofthe National Labor Relations Board. NOTE:The above Statement and Questionnaire are part of theProposal. Signing this Proposal_ on the signature portion thereof shalI arso constiLute signature of this statement and Questionnaire. Bidders are cautioned that rnaking a false certification may subject the certifier to criminal prosecution. NO CONTRACTORI S INDUSTRIAL SAFETY RECORD Pro j ect Ident.if ication Area 4 Residential Neighborhood ADA Curb Ramp lmprovement Project Bid Date 51612024 This info::mation musL include alI const.r:riction wr:rk undertaken 1n t.heState of California by the bidder and any partnershi-p, joint venture orcorporation t.hat any principal of the Lridder participated in as aprincipal or owner for the last three calendar years and the currentcalendar year prior to the date of bici submitt-aI. .separate inf ormationshall be submitt.ed for each particular partnership, jcint venture,corporation or individual bicicler. The bidder may attach any adciitionalinformation or explanation of data, lvhich he would Iike, taken intoconsideration in evaluating the safety record. An explanation must be att-ached of the circumst-ances srlrrouncling any anci all fatal ities *The information required for this item is the same as required for columns 3 t.o 6, Code 10, Occupational f njur:ies, ,summary - OccupationalInjuries and Illnesses, OSHA No. 102. The above information was compilecl to me at this time and I declare information is true and accurate records. Vido Samarzich, lnc. Name of eidder (Pr.int 6829 Billings Place Addre s s Rancho Cucamonga, from the records that are available under penalty of perjury that the wit.hin the limitations of these State Contractor's Lic. No. .& Class 909-987-6377 Telephone Z' cA 91701 ITEM 3 CAI-I]ND,,\R YEARS PRIOR TO ('T-IRRENT YEAR CURRENT YEAR 202t 20?2 2023 TOTAL 2021 No. of Contlacts 4 b 6 16 2 Total dollar aulolutt ol contracts (in t,000's)2000 5000 6000 1 3000 6000 No. of lost workday CASCS 0 0 0 0 0 No. of lost work day CASCS involving pcn-nanent transfer to anotherjob or termination of ellployurent 0 0 0 No. of Iost workdavs 0 0 0 0 0 Srgnature 433210 Class A City Zip Code 0 STATE OF CALTFORNTA COUNTY OF LOS ANGELES Vido Samarzich AFFIDAVIT FOR CORPORATION B]DDER ) )SS ) being firstduly sworn, deposes and says: That he is President of , Vido Samarzich, lnc. a corporation which is the party making the foregoing proposal or bid;that such bid is genuine and not col-Iusive or sham; that saicl bicider has not colluded, conspi-red, connived or agreed., directly or indirecLly,wlth any other bldcler or person f-o put- in a sham bid or that such otherperson shall refrain from biddlngi and has not in any manner sought bycollusion t.o secure any advantage against the City of Diamoncl Bar or any person interested in the proposed conlracL, for hirnself or for alyother person. Subscribed and sworn to befoi:e me t,his day of ,20 SEE ATTACHET) Signature of Officer AdminisLering Oath (Not.ary Publ ic) Si gnaf-u 21 notary public or other officer completing this certificate verifies only the identity of the individual signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on 16;s 3rd day of MaY ,20 24 , by Vido Samarzich proved to me on the basis of satisfactory evidence to be the person(gfwho appeared before me. Signature Bond No.: VIDSA-2241 BID BOND KNOW ALL PERSONS BY THESE PRESENTS that, WHEREAS the City of Diamond Bar (..City,,), has issued an invit.ation for bids for the work described as follows: AREA 4 RESIDENTIAL NE]GHBORHOOD ADA CURB RAMP IMPROVEMENT PROJECT CDBG PRO,]ECT NO. 602604_23 C]P PROJECT NO. SI24IO4 wuunuAs vido samarzich, I!c. , 6829 Billings Place , Rancho cucamonga, CA g17o1 (Name and address of Bidder)("PrinciPdl"), desires to submit a bid to Public Agency for the work. WHEREAS, bidders are required under the provisions of the CaliforniaPublic Contract Code to furnish a form of bidderrs security with theirbid. NOWr otd THEREFORE,we, the underslgned Principal, and Republic , 14728 Pipeline Ave., Suite E ,Chino Hills, CA 91709 (l/ame and address of Suretfl("Surety") a duly admitted surety j-nsurer under the faws of the Stateof California, as Surety, are held and firmly bound unto public Agencyin the penal sum of Ten Percent Of The TotalAmount Bid Dollars ($ 10% Of Bid ), being not .l-ess than ten percent (10%) of thetotal bid price, in lawful money of the United States of America, forthe payment of which sum we}l and truly to be made, we bind ourselves,our heirs, executors, administrators, successors, and assiqns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby boundedPrincipal is awarded a contract for the work by City and within thetime and in the manner required by the bidding specifications, enteredinto the written form of contract included with bidding specifications,furnishes the required bonds/ one to guarantee faithful performance andthe other to guarantee payment for labor and materials, and furnishesthe required insurance coverages/ then thls obligation shall becomenull and voi-d,'otherwise, it shall- be and remain in full force andeffect. 34 In case suit is brought upon this bond, Surety further agrees to payall court costs incurred by City in the suit and reasonable attorneys;fees in an amount fixed by the court. Surety hereby waives theprovisions of California Civil Code S 2845. IN WITNESS WHEREOF, each of which shall for all- purposes be deemed anoriglnal hereof, have been duly executed by principar and surety, onthe date set- forth be1ow, the name of each corporate party being heretoaffixed and these presents duly slgned by its undersignedrepresentative (s) pursuant to authority of its governing body. Dated: May 2nd,2024 P,rr ^ le-rr. " Principa l " Vido Samarzich, lnc. " Surety" Old Republic Suretv Companv ( SeaJ ) Efl ( Seal ) L+!r: __ Note: This bond must be dated, evidence of the authorityfact must be attached. 35 Its ****** affixed this WHEREOF, 1 1th STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS 9n th1g 11th dav of =-i!9!L- 2022 ,personaly came before me, Alan Pavlic Karen J Haffner , to me known to be the individuals and officers of the oLD REpuBLlc suRETy coMpANywho executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: thatthey are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument islne seat of ihe corporation, and that said corporat'e sealand their signatures as such officers were duly afiixed and subscribed to the said instrument by the authority of the board of directors of said corporation. OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be day of August 2022 -,.,{-ltjilriz 5*"_rt corrcur6 ..$7, :;.SEAL S= 2r:" ':. ..'-'aS '2rr,,,f ,,,*','N i OLD REPUBLIC SURETY COMPANY**** POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and appoint: Randy Spohn, Matthew R. Dobyns, Hamilton Kenney, Ashley M. Spohn of Santa Ana, CA its true and laMul Attorney(s)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,(other than bail bonds, bank depository bonds, mortgage deficiency bonds, moftgage guaranty bonds, guarantees of instaltment paper and noteguaranty bonds, self insurance workers compensation bonds guaranteeing payment of benefits, or black tung bonds), as follows: ALL WRITTEN INSTRUMENTS and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys-in-Fact, pursuant to these presents, are ratifled and confirmed.This appointment is made under and by authority of the board of directors at a special meeting held on Februa ry 18, 1gg2. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLDREPUBLIC SURETY COMPANY on February 18,1982. RESOLVED that, the president, any vice-president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appointattorneys-in-fact or agents with authority as deflned or limited in the instrument evidencing the appointment in each case, for and on behalf of the company toexecute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers mayremove any such attorney-in-fact or agent and revoke any Power ofAttorney previously granted to such person. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistantsecretary; or(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal berequired) by a duly authorized attorney-in-fact or agent; or(iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the authorityevidenced by the Power ofAttorney issued by the company to such person or persons. RESoLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any power of Attorney orcertification thereof authorizing the execution and delivery of any bond, underlaking, recognizance, or other suretyship obligations of ihe company; and suchsignature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS OLD REPUBLIC SUREry COMPANY Pre3ident R.S. Bonding & lns Agency lnc My Commission Expires: September 2g, 2026CERTIFICATE /E--:,-.:^- ^r -^r--.J- -^--:--!^- i-^- -^r oRSc22262(3-06) 2;;"-"S (Expirotion ol notory's commission does not involidote this instrument) l, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corpori.ition, CERTIFy that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutierrs of the boar:d of directors set forth in the power ofAttorney, are now in force. -....t:$"#;;?,, ;"-'ot'"o"-"^t'%"'- 74 7og7 ;f. ffii .l! signua and seated at the city of Brookfierd, wr t,is ----2tr9-- day r,-f May 2024'---,j',.,....r'fj / r:. tl.lt CALIFORNIA ALL. PU RPOSE ACKNOWLEDGM ENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE On May 2nd, 2024 before me, ERIKA G. MORGAN, NOTARy pUBLIC, personally appeared RANDY SPOHN x who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/he#their authorized capacity (ies), and that by his/he#their signature(s) on the instrument the person(9, or the entity upon behalf of which the person(s) acted, executed the instrument. I ceftify under PENALTY oF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. v.'&'LtT:Sa!a%ttT!'.'.SIIf *Vifr ffi t"u{ t"'H. ERrKA G MoRGAN { E #-}.FN coruM #2354018 * 9 tF-,i|V.rdtr NOTARy pU3LtC o CALTFORNIA 6 E W "#a^if[:fl:]l',.,, -l @ Though the data below is not required by law, it may prove valuabte to persons retying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER INDIVIDUAL CORPOMTE OFFICER DESCRIPTION OF ATTACHED DOCUMENT trT T XTTtr PARTNER(S)E LrMrreo ATTORNEY-IN.FACT TRUSTEE(S) GUARDTAN/CONSERVATOR OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTTTY(rES) ACKNOWLEDGMENT A notary public or other officer compteting thrs certificate verifies only the identity of the indivldual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ^County ot - San Bernardino ) on May 3,2024 before ,", jesmond G' Watten, ryotary Public (insert name and title of the officer) personallyappeared Vido Samarzich who proved to me on the basis of satisfactory evioence to oe ftre pe whose subscribed to the within instrument and acknowledged to me that he/qb€ltbey executed ine same in ::'/ffi."-1'1"^1f.9 ::l:?y.qfl:,?:l,llillv \':!wy.:ls-n_atrre{g:n the instrument theperson(pXor the entity upon beh-alf of which the persdnfficted, execufed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seat. .I /ffi oEsilot{D G, WARREI,I I8ffi1 n33r*.#236e57e z z\wrrrqp/'l'r:*H'carirornia d { \WW/ Mv comm. Exolres Auo.'4, 2025 ? (Seal)Signature We L. CERTIFICATION OF NON_DISCRIMINATION AI{D AFFIRMATI\IE ACTION As suppliers of goods or services to the City of Dj-amond Bar, the firmlisted below certifies that it. does not discriminate in its employmentwith regards to race, rerigion, sex, or nati-onal orlgln; that it is incompliance wi-th alI federal, sLate, and locaI directives ancl executiveorders regarding non-discrimination in employment; and that it willpursue an affirmative course of action as required by the affirmativeaction guidelines. agree specifically: To establish or observe employment policies which affi::mativelypromote opportunities for minority persons at arl- job leve]s. To communicate this policy to alI persons concerned includlng al1company employees, outside recruiting serr.ices, especially thoseservingi minority communities, and to the minority communities atIarge. To take affi-rmative steps to hire minority employees within the company. FIRI,I Vido Samarzich, lnc. T]TLE Otr SIGNATURE DATE 5t3t2024 PIease incl-ude any additional information available regarding equalopportunity employment programs now in effect within your company: We are an equal opportunity employer. 36 aL. 3. CERTIFICATION V{ITH REGARD TO THE PERFORMANCE OF PFEVTOUS CONTRACTS OR SUBCONTFECTS SUB,JECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILTNG OF REQUTRED REPORTS The bidder -)/-, proposed subcontractor _t hereby certifies thathe has has not -t participate-d in a previous contracL orsubconLract subject to the Equal opportunity Clause, ds reguired bvExecutive orders 10925t L7tL4, or 1L246, and that he has V ^, has noi, filed with the Joint Reporting Committee, the Director of the officeof Eederal Contract. Compliance, a rederal Government contracting oradministering agency, or the former President's Committee on EqualEmployment Opportunit.y, alI reporLs due under t.he appticable filingrequi ::ement-s. Vido Samarzich, lnc. President DATI:May 3 (TTTt,E ) , 2024 NOTE: The above certificatlon is required by the Equal Employmentopportunity Regurations of the secretary of Labor (4L cFR 60-1.7 (b)(1), and must be sr-rbmitted by bidders and proposed subcontractors onlyin connection with contract.s and subcontracts which are subject to theEqual opport.unity Clause. Contracts and subcontracts which are exemptfrom the Equal opportunity clause are set forth in 47 cFR 60-1.5.(Generally only contracts or subcontracts of 910,000 or under areexempt). CurrenLly, Standard Form 100 (EEO-1) is the only report requir:ed by theExecutive Orders or t.heir implementing regulations. Proposed prime contractors and subcontractors who have participat.ed ina previous contract or subcontract subject to the Executive orders andhave not filed the required reports should note that 4t CFR 60-1.7 (b)(1) prevents the award of contracts and subcontracts unless suchcontractor submits a report covering the delinquent period of such otherperiod specif ied by the Federal. Highway Acimini-str:at ion or by theDirector, Office of Federal Contract Compliance, U.S. Department ofLabor. 31 NON_COLIUSION (TO BE EXECUTED BY BIDDER The undersiqned declares: DECLARATION AND SUBMfTTED W]TH BfD) Iam the the President ^EUL Vido Sanrarzich, lnc., the party making penalty of perjury under the laws of the State ofthe foregoing is true and correct and that this foregoing bid. The bid is not made in the interest of, or on behalf of, any undisclosedperson, partnershlp, company/ association, organlzation r orcorporation' The bid is genuine and not corl-usive or itru*. The bidderhas not directty or indirectllz induced or so.Iicited any other bidder toput in a false or sham bid. The bidder has not direct-ly or indirectlycolluded' conspired, connirrecl t or d.greecl wiLLi any bidder ..- ,;;;;.=.i":to put 1n a sham bld, or to refrain from bidding. The bicider has not inany manner' dlrectly or indirectly, sought by agreement/ communication,or conference wj th anyone to f ix the bi d pri-ce of t_he bicider: or anyother bidder, or to fix any overheadr profit r or cost element. of thebi.d pr:i.ce, or of that of any other bidde::. All statements contained in the bid are true. The bldder has not,directly or indirectly, submitteci his or her bicl price or any breakctownthereof, or the contenLs thereof, or divulged informati-on or datarelative thereto, to any corporation, partnership, company/association, organizatlon, bld depository, or Lo any member or agentLhereo'f' Lcl efrecLuaLe a colrusive or sharu bicl, .irrd lras rroL paicl, aircJwilr not pay, any person or entity for such purpose. Any personexecutj-ng thls dec]aration on behalf of a bidrier ilrat is a corporation,partnership, joint venture, limited liability company, limitedliabirity partnership, or any other entity, hereby represents t.irat heor she has fufl power Lo execute, and does execute, this decl_aration onbehalf of the bidder. I declare underCafifornia thatdeclaration is Rancho Cucamonga Vido Samarzich, lnc. executed on fcity] r CA May 3,2024 Idate],atIstate] . Business Name Signature of e i zq Business Address Attach Notary Acknowred.gement Form to this form when submitting 38 ACKNOWLEDGMENT A notary public or other officer completingtfiis certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ^County of San Bernardino on May 3,2024 before me, Desmond G. Warren, Notary public (insert name and title of the officer) personallyappeared Vido Samarzich who proved to me on ' subscribed to the within instrument and acknowledged to me that he/sh6r&ey executed the same inhislbstltfxiflauthorized capacity(igsf and that by his/[etlt@tr-signature(p).on the instrument theperson$f-or the entity upon behalf of which the personJ$.acted, execuled the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoingparagraph is true and correct. WITNESS my hand and official seal. Signature COUNTY LOBBYIST CODE CHAPTER 2.160 COUNTY ORDINANCE NO. 93.0031 CERTIFICATION Name of Firm: Vido Samarzich, lnc. Address: 6829 Billings place, Rancho cucamonoa state: cA Zip code: 91701 Tetephone Number: ( 909 ) glt_6327 Acting on behalf of the above named firm, as its Authorized official, I make the following certification to theLos Angeles County Devetopment Authority (LACDA). 1) lt is understood that each person/entity/firm who applies for a Los Angeles countyDevelopment Authority contract, and as part of that process, shall certify that they are familiarwith the requirements of the Los Angeles county code, chapter 2..160 (Los Angeles countyOrdinance 93_0031 ) and; Vido Samarzich, lnc. (Cortractoysubcontractor) 513t2024 That all persons/entities/firms acting on behalf of the above named firm have and will complywith the County Code, and; That any person/entity/firm who seeks a contract with the Los Angeles County DevelopmentAuthority shall be disqualified therefrom and denied the contract and, shall be liable in civilaction, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting onbehalf of the named firm fails to comply with the provisions of the county code. This certification is a material representation of fact upon which reliance was placed when this transaction wasmade or entered into' submission of this certification is a prerequisite for making or entering into contract withLos Angeles county and the Los Angeres county Deveropment Authority. Authorized Official: 2) 3) ( l)ilc ) President ( iirlc) U.S. DEPARTM REPORT OF ADDITIONAL CLASSIFICATION AND RATE HUD FORM 42304 OlvlB Approvat Number 2S0.1-001 I(Exp 8t3U2022)1. FRoMln"m"and@ 2. PROJECT NAME AND NUMBER 3. LOdA CHARACTER OF CONSTRUCNON Building I ResidentialHeavy f] ott ", (specify) 4. B RI EF DESCRiPTIO t,J O'.PNbJECT 6. WAGE DE. I coev ATTAcHED GE DECISION-EFFEE}TfE woRK CLASStflcATtoN(S) Y WAGE RATES FRINGE BENEFTT(S) (if any) 9. PRIME CONTRACTOR (nanr"-r,ln-r"s")lO,SUBCONT@ (name, address) Check All That Appty: n The work to be perTorn.led by The proposed classificatron The proposed wage rate( the wage decision. The interested parties, additional classification(s) is not performed by a classification in the applicable wage decision. utilized in the area by the construction industry. including any bona fide fringe benefils, bears a reasonable relationship to the wage rates contained in uding the employees or their authorized representatives, agree on the classification(s) and wage rate(s)attached, including applicable wage decision. all criteria. DOL confirmation requested. sifications failto meet all criteria. DOL decision requested. Agency Represerrtaiive (Typed name anct signaturc) FOR HUD USE ONLY LR2000: Log in: Log out: l> o 0) A -n o(r. oo:l-o) zo IUIOtiIQlolo- l>IUl>o (, 7 0r 3rc =J !v O !n() iz 3 r-o s*o: CX co N)O N)A oozr{-7 (){:o.7r' l-{a{o 'Tt !Fo!o VImI 6cE(.)oz{n t.){oFo >lEI EIq =lqBle.219a lq)1l= t6I=lo- lm lE i I I I i I !p o9zc 3u :: I Itoo;ojw 6a'!(/)6 ,:J ot9()-*o ;O N) o No (] OJ-rD l A oo \4w ;, n ,F2 ,, u € r'TtV.x $I1 zo 3 {D o-o- l, GE;e o-; .iIo{EAqd tu2c3crrD t/rt {t4\ Zo, 3(D (x do-o-ls# 3 o):N.o -f) r)o 3E oJ: Zo 3 rD o-oo 0) 3 o):N. o5 T o 9..o-o:J o- -6m =60gdo'o ) {{q \rloq zfociJ3ES(88 tft.P .$ J} > (-)ao !JdLoi 4* *>(\ m cJlnq.s 6iJir; = *- & * > e- Fm vd =H,t0 Yo --iF om(n -{o gl m CtnmU WORKER'S COMPENSATION CERT!FICATION I certify, by my signature below, that I anr aware of the provrsiorrs of Section 3200 of the California Labor Code. S3700 requires every employer lre insured against liability for worker's compensation orto undertake self-insurance in accordance with the provisions of that code. I further certify that I will comply with such provisions before commencing the performance of the work of this contract Date. 5t3t2024 Project Number. cDBG ProjectNo' 602604-23 Project Name: Company Name: Vido Samarzich. lnc. Address: 6829 Billings Place, Rqncho Cucamonga, CA 91701 Print Namet Vido Samarzich NON-SEGREGATED FACILITIES CERTIFICATION Federally Assisted Construction prolects The federally assisted construction 1. Maintain or provide, establishments. contractor certifies that he/she DOES NOT and WILL NOT: for his/her employees, any segregated facirities at any of his/her 2. Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained The federally assisted contractor agrees that a breach of this certiftcation is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregateclfacilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks,locker rooms and other storage or dressing areas, parking lots, drinking fountains. recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, coior, or national origin, because of habit, local custom, or otherwise. The federally-assisted contractor agrees that (except where he/she has obtained identical certificatiorrsfrom proposed subcontractors for specific time periods) he/she will obtain identrcal cerlifications fromproposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exemptfrom the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in his/her files. NOTE: The penalty for making false statements in offers are prescribed in 1g U.S.C. 1001 . Date: 51312024 CDBG Project No. 602604-23 Project Number: CIP No. 9124104 Company: Vido Samarzich, lnc. 6829 Billings Place, Rancho Cucamonga, CA 9,1701 Tile: President By: PAST PERFORMANCE CERTIFICATION With rEard to performance of previous contracts or subconlracts sutriect to the Equal Opportunity Clause anclfiling of required reports ffre g6iOOer, nproposed sub-contractor, hereby certifies that he/she nhas, nhas not, participated in a previous contract or subcontract subject t,o the Equal Opportunity ilurr", as iequired byExecutive Orders 10925, 11114, or 11246, and that he/she Dlras, nhis not, filed witn ihe JointReporting Committee, the Director of the Office of Federal Contract Compliance (OFCCp), aFederalGovernment contracting or administering agency, orthe former President's Committee onEqual Employment Opportunity, all reports due under the applicable filing requirements. Date. 513t2024 Project Number: City of Diamond Bar SBBNcoPl1r2e4clilo 602604-23 ContractAward: $ ll &b Awarding Agency. Contractor Name:Vido Samarzich, lnc.Total Number of Enrployees 23 Title: President NOTE: The above cerlification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60'1.7(bX1), and must be submitted by bidders and proposed subcontiactois only in connection with contractsand subcontracts which. are subject to the equal opportunity clause. Contracts and subcontracts which are exempt fromthe equal opportunity clause are set forth in 41 cFR 60-i.5 (Generally only contracts or subcontracts of $to,boo orunder are exempt). Proposed prime contractors and subcontraclors who have participated in a previous contract or subcontract subject tothe Executive orders and have not filed the required reports shouio note thai41 cFR 60-1 .7(bX1 ) prevents the award ofcontracts and subcontracts unless such contractor submits a report covering the delinquent'period or such other periodspecified by the U.S. Department of the lnterior or by the Director, Office of Federal Contract Compliance, U.S.Department of Labor. SF-100 (EEO-1) must be fited bv; (A) All private employers who are:(1) Subject to Title Vll of the Civil Rights Act of 1964 (as amended) with 100 or more emptoyees.(2) Subject to Title Vll who has fewer than 100 employees, if the company is owned or affitiated with another company, or there is centralized ownership, control or management so that the group legally constitutes a single enterprise, and the entire enterprise employs a totat of 100 or more empioyels.(B) All federal contractors (private employers), who:(1) Are not exempt as provided for by 41 CFR 60-1.5(2) Have 50 or more employees, anda. Are prime contractors or first-tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; orb. Serve as a depository of Government funds in any amount, orc- ls a financial institution, which is an issuing, and paying agent for U.S. Savings Bonds and Notes. By: EQUAL EMPLOYMENT OPPORTUNITY GOMMITMENT TO:Southern California District Council of Laborers (Nanre of Labor Union, Workers Representative, elo. 1'123 Parkview Dr., Suite 300, Covina cA 91724 Name of Business (contractor;' Vido Samarzich, lnc' . Area 4 Residential Neighborhood ADAProject Name: curn namp impiovenrEnfFroiect Project Number: 3H,f":5,'r?U" 60260+23 The Undersigned currently holds a contract with City of Diamond Bar fundsoftheU.S.Government,oraSubcontract,involving contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246, the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligaiion not to discriminate in employment includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion;2. Recruitment, advertising or solicitation for employment;3. Treatment during employment;4. Rates of pay or other forms of compensation;5. Selection for training, including apprenticeship; and6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246. Copies of this notice will be posted by the unclersigned in conspicuous places available to employees or applicants for employment. Vido Samarzich ('l'rint Nanrc) 5t3t2024 President ( I irlc) TO: EQUAL EMPLOYMENT OPPORTUNITY GOMMITMENT Southern California Cenrent [\,lasons (Nante of LatLor Union, Workers Representative, etc 5417 Peck Road, Arcadia, CA 91006 (Adr:iress) Name of Business (Cor'rtractor.): trg_llTarzich, lnc. Area 4 Residentiat Neighborhood ADAffOJeCI Name: Curb Ramp lmprovement Project p roj e ct N u m be r : 3 PpBfiioPlori2e4cl Uo 602604 23 The Undersigned funds of the U. S. currently holds a contract with City of Diamond Bar Government, or a subcontract , involving contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246, the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. Tnis obtigaiion not to discriminate in employment includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion;2. Recruitment, advertising or solicitation for employment;3. Treatment during employment;4. Rates of pay or other forms of compensation;5. Selection for training, including apprenticeship; and6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. Vido Samarzich (l)rint Nrnrc) 513t2024 President (l)at() EQUAL EMPLOYMENT OPPORTUNITY GOMMITMENT TO:Operating Engineers (Nanre ofLabor Union, Workers Representative, etc. 150 Corson St., Pasadena, CA 91109 Name of Business (Contractor;' Vido Samarzich, lnc' Area 4 Residential Neighborhood ADA PfOJeCt Name: curb Ramp lmprovenr6nt Project project N u m ber: 3Bt-"":5",,r"*1 No 602604-23 The Undersigned currently holds a contract with City of Diamond Bar fundsoftheU.S,Government,oraSUbContract,involving contract You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246, the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligaiion not to discriminate in employment includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion;2. Recruitment, advertising or solicitation for employment;3. Treatment during employment;4. Rates of pay or other forms of compensation;5. Selection for training, including apprenticeship; and6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. Vido Samarzich (l'rint N^nrdJ 5t312024 President (1 irlc)(l);!ic) California Public Contract Code requires every bid on every public works contract of a public to include a declaration under penalty of perjury under the laws of the State of California, in the following form: NONCOLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID The undersigned declares: r um tr,8'il'il%r----, the party making the foregoing bid. Vido Samazich, lnc. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a slram bid, or to refrairr fronr bidding. The biclder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a bidder that is a corporation, partrrership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder. I declare under penalty of perjury under the laws of the State of California that the foreqoinq is true and correct and that this dectararion is executed of'131?3u,.r, ^ff1i?i?ililTlil3fi.r: FEDERAL LOBBYIST CERTI FICATION Vido Samarzich, lnc.Name of Firm. Address: 6 State: CA Zip Code: 91701 TelephoneNumber: ( 909 )L Acting on behalf of the above namecifirm as its Authorized Official, I make the following Cerlification to the U. S Department of Housing and Urban Development and the Los Angeles Courrty Developrnent Auflrority (LACDA). 1) No Federal appropriated funds have been paid by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Fecleral contract, the making of and Federal grant, loan or cooperalive agreement, and any extension, continuation, renewal, amendment, or modification thereof, and; lf any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the above named firm shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions, and; The above name firm shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreement) and that all sub-recipients shall certify and disclose accordingly. This cer-tification is a material representation of fact upon v,rhich reliance was placed when thrs transaction was made or entered into. Submission of this certification is a prerequisite for rraking or entering into the transaction imposed by Section 1352 Title 31, U. S. Code. Any person who fails to file the requirecl certifrcation shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official: Vido Samarzich, lnc. 2) 3) 5t3t2024 ( l)ilte) President 0",, lllr-g (Rev, October 20'18) Department of the Treasurv lnternai Revenue Service ' Request for Taxpayer ldentification Number and iertification ) .Go lo www.irs.govlFormWg for instructions and the latest information. re tax return). Name is Give Form to the requester, Do not send to the lRS. Exemption from FATCA repoding code (if any) (Applies to accaunts naifiained outside the lJ.S.) 4 Exernptions (codes apply only to certarn cnttttes, not indtvtduals; see instructions on page 3): Exempt payee code (if any) t I'tame (ai srrown 6iliil Vido Samarzich, lnc. entity name, it Oitterent trom aOore ei q) (E tro o o o 6 E ol '6 1otcLttt, IototcDl otoi. o o Requesler's name anoioOres Enter your TIN in the approoriate oor. ft,u-rr$.rGJ.rr-,n:m"n in" nun.,u gr* on lin" r to avoio [T|3f,:i*"1.f,:n;l*l_.:y,i:ll"U:::li191u'riv],"ol, *"i,r sec,,rily number (sSN). However, ror aresjdent atien, sote proprietor, or disregardelJ ".trtvl J* ir,""ir.;ffi;{ i"l i,# ,ilili. I:L",I,"J; t"' , ii^l],?i;l is vour emplover identiricatidn "rro"i teir.ii ri you do not have a numbe,l see How to set a Note: lf the account is in more than one name, see the instructions for jine 1. Also see what Name andNumber To Give the Requester for gulOetines on whos]e number to enter.